99454

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days

Medicare pricing data for 14,759 providers across 51 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 1.8 million services annually. Even small pricing inefficiencies here affect millions of patients. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days (HCPCS code 99454) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $50.58, but hospitals typically charge $128.99 — a 2.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.12

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $50.58, your out-of-pocket cost would be approximately $10.12. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$50.58
Average Hospital Charge
$128.99
Markup Ratio
2.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$128.99
Medicare Allowed$50.58
Medicare Payment$38.89

Hospitals charge 2.6x more than what Medicare allows for this procedure. Medicare actually pays $38.89 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$59$147384,321+17.1%
California$58$1321,412333,433+14.6%
New Jersey$57$14883185,381+12.8%
New York$57$1791,166129,731+12.0%
Hawaii$56$96273,628+9.8%
Connecticut$55$1569028,644+8.7%
Alaska$54$86201,896+6.8%
Maryland$54$12846069,725+6.4%
Massachusetts$53$13615915,475+4.5%
Pennsylvania$52$11562035,777+1.9%
Colorado$51$10513610,320+1.3%
Illinois$50$12638644,105-0.7%
Washington$50$12919814,229-1.2%
Montana$50$177221,230-2.1%
Puerto Rico$49$53422-2.2%
Delaware$49$101518,184-2.2%
Virginia$49$13045377,933-2.2%
Nevada$49$14120125,021-3.4%
New Hampshire$48$8461,700-4.2%
Oregon$48$171515,652-4.2%
Wyoming$48$94341,877-4.3%
Minnesota$48$1362144,222-5.5%
Michigan$48$11839324,683-5.7%
Texas$48$1291,468179,054-6.0%
Florida$47$105950161,135-6.4%
Arizona$47$11960477,061-6.7%
South Dakota$47$121141,153-7.0%
Maine$46$102696-9.5%
North Carolina$46$12940631,676-10.0%
Rhode Island$45$12817253-10.3%
Wisconsin$45$142883,087-10.4%
Georgia$45$11955690,686-11.2%
Nebraska$45$798510,109-11.3%
Kansas$45$1008810,753-11.4%
Missouri$45$12716020,098-11.9%
Ohio$44$10122917,453-12.2%
South Carolina$44$12342025,903-12.2%
Tennessee$44$12336440,223-12.3%
Utah$44$1081139,606-12.6%
Indiana$44$12638514,187-13.2%
Iowa$43$12729917,060-14.1%
West Virginia$43$115261,939-14.2%
Alabama$43$10134025,061-14.3%
Louisiana$43$15924619,314-14.5%
Oklahoma$43$9817612,312-14.5%
New Mexico$43$111936,482-14.9%
Kentucky$42$108935,813-16.1%
Mississippi$42$9927129,195-17.5%
North Dakota$42$2002222-17.6%
Arkansas$42$13517915,365-17.6%
Idaho$41$122654,232-18.1%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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